Objectives To compare the hemodynamic effects and ventricular activation sequence associated with the respective pacing of the right ventricular outflow tract (RVOT) and right ventricular apex (RVA). Methods 79 patients with complete atrioventricular block (AVB) or sick sinus syndrome (SSS)to undergo permanent ventricular stimulation either at the right ventricular apex (RVA) (n = 38) or right ventricular outflow tract (RVOT) (n =41) were selected. The left ventricular ejection fraction (LVEF),cardiac index (CI), mitral E/A ratio and QRS duration were recorded before implantation of pacemaker and 6 or 12 months after implantation. Results There were no significant differences in CI , LVEF, E/A between RVOT and RVA pacing(P ＞0. 05). Compared with normal sinus rhythm, the QRS duration was significantly lengthened when pacing at RVOT or RVA (P ＜0. 05). RVA pacing was significantly longer than RVOT in QRS duration (P ＜ 0. 05). Conclusions There was no significant difference with the hemodynamic effect between RVOT and RVA pacing in subject with normal heart function. Compared with RVA pacing, RVOT pacing remained relatively normal ventricular activation sequence.

Objective To explore the criminological characteristics and appraisal traits of capacity for responsibility in murder by patients with mental retardation and schizophrenics. Methods 20 cases who were appraised as mental retardation and 58 ones as schizophrenics were retrospectively compared. Results They were similar in gender, age, occupation, casualty and criminal plan , but different in criminal motives, criminal targets, action after crimes, repeated crimes. Conclusion The irritability mental retardation patients and schizophrenics with delusion of persecution or jealousy would be warded strictly. The criminological characteristics is helpful to assess the capacity for responsibility as well as differential diagnose mental retardation and schizophrenics.

Objective To compare the analgesic effect of dexmedetomidine and propofol on patients with coronary heart disease undergoing noncardiac surgery.Methods 86 patients in our hospital from Sep 2009 to Sep 2011 aged 55-76 years weighing 42-60 kg,who were scheduled for epidural anesthesia in routine,were randomly assigned to 2 groups:dexmedtomidine (Dex) group and propofol group (n=43,each).Visual analogue scale/score (VAS) analgesia score and ramsay sedation score were used to observe the analgesic effect after surgery.Serum concentration of cortisol,insulin and glucose were observed and compared between Dex and propofol group before and 4,24,48h after surgery.Patient satisfaction was surveyed.Results The analgesic effect evaluated by VAS and Ramsay scores was better in Dex group than in propofol group at different time after surgery (t=5.368,2.262,7.147,5.881,7.861,4.810,all P＜0.05).Serum concentrations of cortisol,insulin and glucose were lower in Dex group than in propofol group before and 4,24,48 h after surgery (t=3.076,2.042,4.090,all P＜0.05).The satisfaction rate was 93.0％ (40/43) in Dex group.Conclusions Dexmedetomidine has a better analgesic effect than propofol,and it is safe and feasible for patients with coronary heart disease undergoing noncardiac surgery.

Objective To investigate the influencing factors of the clinical outcome of patients with femoral neck fracture after operation .Methods 180 patients with femoral neck fractures were chosen ,the clinical data were statistical analyzed,recording body condition of concurrent disease and preoperative in all patients gender ,age,level of hemoglobin ,serum albumin level ,injured time and operation time interval of time ,before the operation , The influence of clinical outcome in patients of 1 years after fracture of neck was analyzed .Results The death patients and survival between patients with concurrent disease (89.6% vs 10.4%),physical status classification (84.9% vs 15.1%), hemoglobin(98.4%vs 1.6%),serum albumin level(98.9% vs 1.1%) and total lymphocyte number (96.6% vs 3.4%) had statistical significance(χ2 =7.227,13.855,16.201,6.678,4.649,all P<0.05).Multivariate Logistic regression analysis ,concurrent disease ,>2 physical status classification in the grade ⅢorⅣ,level of hemoglobin <100g/L,level of serum albumin <35g/L and total lymphocyte number <1.5 ×109/L were risk factors of clinical out-come of femoral neck after surgery .Conclusion Concurrent disease ,physical status classification ,hemoglobin levels , serum albumin level and total lymphocyte number are clinical risk factors increased mortality for patients with fracture of neck of femur .

Objective To examine the change of TGF-?1 in the bloods of rats which were induced by tetrachoride during the different times and to explain the mechanism of the change.MethodsThe experimental liver fibrosis induced by tetrachloride in rats was treated by matrine compound injection.Serum TGF-?1 and pathological changes in liver tissue were observed in control group,model group and therapy group during the time of the 4th,6th and 9th week.ResultsThere was an obvious change of TGF-?1 in the blood in different time and different groups.ConclusionMatrine compound injection has an antifibrogenetic action and TGF-?1 can reflect the change of liver fibrogenesis of different time as an index.

Objective To observe the real-time efficacy of balance acupuncture in treating primary hypertension. Method Totally 160 patients with primary hypertension were randomized into a treatment group and a control group, 80 in each group. The treatment group was intervened by balance acupuncture, while the control group was by oral administration of Captopril. The blood pressure and symptom score were observed before and after intervention. Result There were no significant differences in comparing the total effective rate at different time points between the two groups (P>0.05). There was a significant difference in comparing the headache score in male patients at 30 min after treatment between the two groups (P<0.05). Conclusion Balance acupuncture is an effective method in treating primary hypertension, and can release headache of the patients.

Objective To investigate the application of expanded p01ytetrafluoroethylene(ePTFE)grafts in upper arm to build arteriovenous aCCeSS for hemodialysis. Methods ePTFE graft vascular access was built in the upper arm in 20 uremia patients.Three operation strategies were applied according to the reference,including loop grafts connected axillary artery and axillary vein,straight graft connected axillary artery and elbow basilic vein,and bridge connected elbow brachial artery and axillary vein. Results Twenty operations were successful and after 6-8 weeks the fistula of all cases were used in hemodialysis.The blood flows were 220-300 ml/min without re-circulation found.Conclusion ePTFE graft arteriovenous vascular access in the upper arm could be an alternative for hemodialysis patients who are difficult to build native arteriovenous fistula.

Objective To explore the clinical significance of anti-nuclear protein B23 antibody in systemic sclerosis. Methods Enzyme-linked immunosorbent assay was employed to detect the serum antinuclear B23 autoantibody. Mann-Whitney U test was used to compare the clinical and autoantibody profiles between SSc patients with B23 antibody and those without B23 antibody. Logistic regression analysis was employed to analyze the correlation between B23 antibody and clinical manifestations and autoantibody profiles. Results Mann-Whitney U test showed that, forced vital capacity (FVC) diffusion capacity of CO (DLco) in B23 positive SSc was significantly lower than that in B23 negative counterparts, pulmonary artery hypertension was more prevalent in B23 positive SSc patients. While anti-fibrillarin, anti-U1RNP, and antic entromere antibodies were more prevalent in B23 positive SSc. Multivariate logistic regression showed that anti-B23 antibody positivity was an independent risk factor for pulmonary artery hypertension in SSc (OR=123.92, 95％CI 26.67～575.66, P＜0.01), and a protective factor for severe gastrointestinal involvement (OR=0.08, 95％CI 0.01 ～0.70, P＜O.05). Logistic analysis showed that anti-B23 antibody was correlated with antifibrillarin (OR=11.50, 95％CI3.85～34.37, P＜0.01) and anti-U1RNP antibodies (OR=3.43, 95％CI 1.01～11.63, P＜0.05), and correlated with different degree of pulmonary artery hypertension. Conclusion The pulmonary artery pressure should be monitored closely in those SSc patients with a positive B23 antibody.

Objective To compare the clinical efficacy of minimally invasive removal of intracranial hematomas and medical con-servative treatment for hypertensive cerebral hemorrhage .Methods A total of 75 patients with hypertensive cerebral hemorrhage were collected and randomly divided into two groups according to the treatments :38 patients treated with conservative medicine and 37 patients treated with minimally invasive removal of intracranial hematomas based on standard drug therapy .Neurological impair-ment and recovery of self-care ability of patients in both groups before and after three weeks and six weeks of treatment were scored by National Institute of Health Stroke Scale (NIHSS) .Changes of diffusion tensor imaging before treatment and after two weeks of treatment were evaluated by fractional anisotropy value (FA) .Results There was no significant difference between neurological im-pairments of the patients in two groups before treatment .But the recovery degree of functional impairment and muscle nerve in min-imally traumatic treatment group was more significant than those in the conservative medical treatment group after treatments . There was significant difference between two groups (P< 0 .05) .Conclusion Minimally traumatic of hematomas is an effective method of treating hypertensive intracerebral hemorrhage .

Objective To investigate whether hydrogen-rich saline could ameliorate the expressions of cytokines in a rat model of inflammatory pain through activating heme oxygenase-1 (HO-1).Methods Eighty male Sprague-Dawley (SD) rats,weighing 180 ～ 220 g,were randomly divided into five groups (n =16 in each group):Control group (Con),inflammation pain group (CFA),inflammation pain + hydrogen-rich saline group (CFA + H2),inflammation pain + HO-1 inhibitor Znpp-Ⅸ group (CFA + Znpp-Ⅸ),and inflammation pain + hydrogen-rich saline + HO-1inhibitor Znpp-Ⅸ group (CFA + H2 + Znpp-Ⅸ).The mechanical withdrawal threshold (MWT) and thermal withdrawal latency (TWL) were tested on days 1 (T1),2 (T2),3 (T3),5 (T4),7 (T5),and 14 (T6) after inflammation pain.The expressions of spinal HO-1 mRNA and protein were measured with real-time quantitative polymerase chain reaction (RT-PCR) and Western blot,and spinal inflammatory cytokines were measured with enzyme-linked immunosorbent assay (ELISA) on day 7 after inflammatory pain.Results Compared to Con group,MWT and TWL were significantly reduced;the spinal HO-1 mRNA level,protein expression and activity were increased;and the levels of tumor necrosis factor-α (TNF-α),interleukin (IL)-1β,IL-6 and IL-10 in spinal tissues were also increased in CFA group (P ＜ 0.05).Compared to CFA group,MWT and TWL were significantly increased;the spinal HO-1 mRNA level,protein expression and activity were further increased;and the levels of TNF-α,IL-1β and IL-6 were decreased,while IL-10 was further increased in CFA + H2group (P ＜ 0.05).Compared to CFA + H2 group,MWT and TWL were decreased;the spinal HO-1 mR-NA level,protein expression and activity were decreased;and the levels of TNF-α,IL-1β and IL-6 in spinal tissue were significantly increased,while IL-10 was decreased in CFA + H2 + Znpp-Ⅸ group (P ＜0.05).Conclusions Hydrogen-rich saline can ameliorate the mechanical and thermal allodynia in a rat model of inflammatory pain,and reduce the release of inflammatory cytokines via activating HO-1.